5-year follow-up of LASIK for hyperopia

To assess the long-term efficacy and stability of LASIK for hyperopia (+0.75 to +7.00 diopters [D]). Retrospective follow-up study of a previous phase III multicenter clinical trial (unpublished data). Patients who had been treated for hyperopia (33 individuals, 47 eyes) attended follow-up 5 years after surgery. The preoperative mean spherical equivalent at the spectacle plane was +3.58 D (range, +0.75 to 7.00 D), and the attempted mean spherical correction at the corneal plane was +3.18 D (range, +1.00 to +6.00 D). Treatments were performed using a Moria LSK One microkeratome and a Summit Technology SVS Apex Plus excimer laser fitted with an Axicon. Manifest refraction, uncorrected visual acuity, best spectacle-corrected visual acuity, corneal transparency, complications, and patient satisfaction were recorded. At 5 years, for treatments between +1.00 to +3.00 D, 71.0% of eyes were within ±1.00 D of the intended correction, and for treatments between +3.5 to +6.0 D, 37.5% of eyes were within ±1.00 D of intended correction. From 12 to 54 months after surgery for all patients, there was a hyperopic shift of +0.53 D (range, −0.13 to +3.13 D), with 51.1% of eyes experiencing an increase of +0.50 D or more and 27.7% of eyes showing a hyperopic shift of more than +1.00 D. This hyperopic shift was +0.67 D (range, 0 to +1.125 D) for patients younger than 40 years of age and +0.44 D (range, −1.33 to +1.50 D) for patients between 43 and 55 years of age. LASIK was moderately effective for the correction of low degrees of hyperopia. However, there was regression throughout the 5-year follow-up that was greater than would be expected as a result of aging. Long-term stability of hyperopic LASIK refractive corrections, therefore, is uncertain.